127 articles - From Friday Aug 18 2023 to Friday Aug 25 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
|---|
| Endosc Int Open |
Prospective assessment of the accuracy of ASGE and ESGE guidelines for choledocholithiasis. ESGE and ASGE guidelines have similar accuracy for diagnosis of choledocholithiasis. However, ESGE criteria result in more patients needing additional testing, but also a smaller proportion of patients undergoing unnecessary ERCP. |
| Gastrointest Endosc |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
|---|
Systematic review with meta-analysis: Medical therapies for treatment of ulcerative proctitis. Topical 5-ASA and corticosteroids are effective for active UP. Topical 5-ASA may be effective for maintenance of remission. Tacrolimus may be effective for induction of remission. Etrasimod may be effective for induction and for maintenance of remission. Trials should include UP to expand the evidence base for this under-represented population. |
Systematic review: Interventions for alcohol use disorder in patients with cirrhosis or alcohol-associated hepatitis. Baclofen is the only intervention with randomised trial evidence for significant benefit in patients with cirrhosis. Non-randomised studies also point to non-pharmaceutical interventions possibly improving clinical outcomes. |
| Am J Gastroenterol |
Effect of Behavioral Interventions on the Uptake of Colonoscopy for Colorectal Cancer Screening: A Systematic Review and Meta-analysis. Behavioral interventions increase screening colonoscopy completion and should be adopted in clinical practice. In particular, patient navigation and multi-component interventions are the best-studied and most effective interventions. |
| Clin Gastroenterol Hepatol |
RISK OF CANCER RECURRENCE IN PATIENTS WITH IMMUNE-MEDIATED DISEASES WITH USE OF IMMUNOSUPPRESSIVE THERAPIES: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS. In patients with immune-mediated diseases and history of malignancy, there we observed similar rates of cancer recurrence in those on no immunosuppression compared to different immunosuppressive treatments. |
| Endosc Int Open |
EUS-guided gastroenterostomy vs. surgical gastrojejunostomy and enteral stenting for malignant gastric outlet obstruction: a meta-analysis. EUS-GE is the most successful approach to treating MGOO, exhibiting a lower risk of recurrent obstruction compared to ES, and fewer AEs compared to SGJ. |
Safety and efficacy of underwater versus conventional endoscopic mucosal resection for colorectal polyps: Systematic review and meta-analysis of RCTs. Colorectal U-EMR results in higher en-bloc resection and lower recurrence rates when compared to C-EMR. Both techniques have comparable resection times and safety profiles. |
| Endoscopy |
Comparative Diagnostic Yield of Different Endoscopic Techniques for Tissue Sampling of Upper Gastrointestinal Subepithelial Lesions: A Network Meta-analysis. EUS-FNB and MIAB seem to provide better performance, while bite-on-bite sampling is significantly inferior to the other techniques. MIAB seems to be the best option for smaller lesions, whereas EUS-FNA remains competitive when ROSE is available. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Age at treatment initiation predicts response in children with chronic hepatitis B. In children with CHB receiving antiviral treatment, HBsAg loss and HBeAg clearance were frequently observed. Age at treatment initiation can predict treatment response, including HBsAg loss and HBeAg clearance. |
Increasing healthcare costs in inflammatory bowel disease 2007-2020 in Sweden. Between 2007 and 2020, excess costs shifted from productivity losses to direct healthcare costs; that is, the patients' compensation for sickness absence decreased, while society increased its spending on medications. Medication costs were driven both by expanding use of TNF inhibitors and by high costs for newer targeted therapies. |
Proton pump inhibitor use and the risk of metachronous gastric cancer after H. pylori eradication in patients who underwent endoscopic resection for gastric neoplasms: A population-based cohort study. Long-term PPI use is associated with an increased risk of metachronous gastric cancer in patients who undergo H. pylori eradication therapy after endoscopic resection of gastric neoplasms. |
STAR SIGN study: Evaluation of COVID-19 vaccine efficacy against the SARS-CoV-2 variants BQ.1.1 and XBB.1.5 in patients with inflammatory bowel disease. Patients with IBD who are treated with anti-TNF biologics show impaired neutralisation against novel omicron sublineages BQ.1.1 and XBB.1.5 and may benefit from prioritisation for future variant-adapted vaccines. |
| Am J Gastroenterol |
A Review of Available Medical Therapies to Treat Moderate to Severe Inflammatory Bowel Disease in 2023. Additionally, safety considerations and use in special populations is summarized with proposed algorithms for positioning therapies. The aim is to provide a synopsis of high impact data and aid in outpatient treatment decision making for IBD patients. |
Advances in endohepatology. These involve, amongst others, EUS-guided liver biopsy, EUS-guided portal pressure gradient measurement, coil and glue embolization of gastric varices… In addition to its conceptually attractive technical and innovative characteristics, "endo-hepatology" is also an appealing practical option for daily practice as it can be offered as a "one-stop-clinic" intervention where comprehensive endoscopic diagnostic and/or therapeutic testing is performed in a single outpatient visit. In this review, we will discuss current trends and future developments within endo-hepatology and the remaining hurdles to overcome. |
ENDOSCOPIC VACUUM THERAPY FOR UPPER GASTROINTESTINAL LEAKS AND PERFORATIONS: ANALYSIS FROM A MULTICENTER SPANISH REGISTRY. Endoscopic vacuum therapy is safe and effective in cases of anastomotic leakage and perforations of the upper digestive tract. The early use of EVT improves the efficacy of this technique. |
Endoscopist and procedure-level factors associated with increased adenoma detection with the use of a computer-aided detection (CADe) device. The application of CADe devices in clinical practice should be carefully evaluated. Larger studies should explore differences in endoscopist-related factors for CADe. |
Gastric Cancer Incidence and Mortality after Endoscopic Resection of Gastric Adenoma: A Nation-wide Cohort Study. Removal of gastric adenoma resulted in lower-than-expected mortality but higher-than-expected incidence due to gastric cancer than in the general population. Our analyses indicated the importance of the follow-up strategy after removal of gastric adenoma. |
Towards AI-Augmented Clinical Decision Making: An Examination of ChatGPT's Utility in Acute Ulcerative Colitis Presentations. Out of 20 cases, ChatGPT's assessments were found to be 80% consistent with gastroenterologist evaluations and indicated a high degree of reliability. This suggests that ChatGPT could provide as a clinical-decision support tool in assessing acute Ulcerative colitis, serving as an adjunct to clinical judgment. |
| Clin Gastroenterol Hepatol |
COLORECTAL CANCER STAGE-DISTRIBUTION AT FIRST AND REPEAT FECAL IMMUNOCHEMICAL TEST SCREENING. FIT-based screening is effective in downstaging CRC, also at repeat screening. Increasing the FIT cut-off level has limited impact on the stage-distribution of detected CRCs, though greatly affects CRC detection and thus is important to keep low. |
Hepatocellular Carcinoma Surveillance Patterns and Outcomes in Patients with Cirrhosis. HCC surveillance patterns vary in clinical practice and are associated with differing clinical outcomes. While awaiting data to determine if CT or MRI surveillance can be performed in a cost-effective manner in selected patients, AFP has a complementary role to ultrasound-based surveillance, supporting its adoption in practice guidelines. |
Point-of-care non-invasive prediction of liver-related events in patients with NAFLD. The ANTICIPATE-LRE models, and especially the ANTICIPATE-NASH-LRE model, could be valuable validated clinical tools to individually assess the risk of LRE at 3 years in patients with NAFLD/NASH. |
| Endosc Int Open |
Bowel cleansing effectiveness and safety of 1L PEG + Asc in the real-world setting: Observational, retrospective, multicenter study of over 13000 patients. This large-scale, real-world study demonstrates the effectiveness of 1L PEG + Asc in the total and right colon, with a low percentage of patients with AEs in routine clinical practice. |
Incidence of retained biopsy specimens after esophagogastroduodenoscopy and colonoscopy. Retained specimens are startingly common in standard gastrointestinal endoscopic procedures and could potentially change diagnoses and management. Quality improvement measures should be instituted to monitor prevalence of retained biopsies and methods to prevent them should be developed. |
Initial experience of transpapillary gallbladder biopsy using newly designed device delivery system. A good indication for this technique is considered to be wall thickening at the gallbladder fundus, where it is difficult to differentiate between benign and malignant lesions by imaging modalities such as ultrasonography or endoscopic ultrasound. The addition of transpapillary gallbladder biopsy may be advantageous when performing bile juice cytology using a nasogallbladder drainage tube for the diagnosis of gallbladder disease. |
Initial multicenter experience using a novel articulating through-the-scope traction device for endoscopic submucosal dissection. Dynamic real-time traction may lower the technical difficulty of ESD. Additional studies are needed to assess its cost-effectiveness and compare its usefulness with other traction devices and techniques during ESD. |
| Endoscopy |
CLINICAL OUTCOMES OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR SUPERFICIAL ESOPHAGEAL NEOPLASIA IN CLOSE PROXIMITY TO ESOPHAGEAL VARICES: A MULTICENTER INTERNATIONAL EXPERIENCE. ESD is feasible and effective for SEN located at or adjacent to EV in cirrhotic patients. Albeit, majority of the EV in our study were small in size, when expertise is available, ESD should be considered as a viable option for these patients. |
| Gastroenterology |
HIF1A stabilization restores epigenetic control of Nos1 expression and reverses gastroparesis in female diabetic mice. Pharmacological HIF1A stabilization is a novel, translatable approach to restoring nitrergic signaling and treating diabetic gastroparesis. The newly recognized effects of HIF1A on chromosome topology may provide insights into physioxia- and ischemia-related organ function. |
Predicting Incident Adenocarcinoma of the Esophagus or Gastric Cardia Using Machine Learning of Electronic Health Records. K-ECAN is a novel, internally validated tool predicting incident EAC/GCA using EHR data. Further work is needed to validate K-ECAN outside VHA and to assess how best to implement it within EHRs. |
Prevalence and Burden of Illness of Rome IV Irritable Bowel Syndrome in the United States: Results from a Nationwide Cross-Sectional Study. In this nationwide US survey, we found that Rome IV IBS is slightly more prevalent (6.1%) versus prior estimates (4.7%-5.3%). Additional research is needed to determine if this higher prevalence is in part due to the COVID-19 pandemic during which this study was conducted. |
| Gastrointest Endosc |
A new endoscopic closure technique, "internal traction-assisted suspended closure," for gastrointestinal defect closure (with video): a pilot study. The suspended closure technique is a simple, reliable, and easy-to-use technique for large full-thickness defects following endoscopic resection. |
Adverse events of self-expandable metal stent placement for malignant distal biliary obstruction: A large multicenter study. Pancreatic duct without tumor involvement, intact papilla, and SEMS placement across the papilla were independent risk factors for acute pancreatitis, and tumor involvement to the OCD was an independent risk factor for cholecystitis. The risk factors for food impaction and/or sludge, stent migration, and tumor ingrowth differed among types of SEMS. |
Clinical impact of pancreatic steatosis measured by computed tomography on the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis: A multicenter prospective trial. Pancreatic steatosis is a significant risk factor for PEP for which preventive measures should be considered. Standardized measurement protocols to assess PS by CT are needed. |
Conventional Versus Oblique Fiber Sparing Endoscopic Myotomy for Achalasia Cardia: A randomized controlled trial. Sparing of sling fibers has no significant impact on the incidence of significant reflux esophagitis after POEM. Novel strategies need to be explored to prevent reflux after POEM. (NCT04229342). |
Defining the "true acid reflux" after per-oral endoscopic myotomy for achalasia: a prospective cohort study. A manual review of pH tracings helps identifying "true acid reflux" in post-POEM achalasia patients. Pre-procedural IRP can be a predictive factor in determining patients at risk for this outcome. |
True diagnostic ability of endoscopic ultrasound-guided fine needle aspiration/biopsy for small pancreatic cancer =10 mm and salvage diagnosis by pancreatic juice cytology: A multicenter study. The true success rate/sensitivity of EUS-FNAB for PDAC = 10 mm was relatively low. When EUS-FNAB for a pancreatic lesion = 10 mm strongly suspected to be PDAC is unsuccessful or yields a negative result, PJC is recommended. |
Validation of Prediction Tools for Gastrointestinal Bleeding in Patients on Dual Anti-Platelet Therapy After Percutaneous Coronary Intervention. The SIGE score may help to predict rebleeding, which was shown to be associated with an increased risk of MACE. Further external validation is needed. |
| Gut |
APC and P53 mutations synergise to create a therapeutic vulnerability to NOTUM inhibition in advanced colorectal cancer. Our findings that a single agent targeting the extracellular enzyme NOTUM is effective in treating highly aggressive, metastatic adenocarcinomas in preclinical mouse models and human organoids make NOTUM and its glypican targets therapeutic vulnerabilities in advanced CRC. |
Dietary wheat amylase trypsin inhibitors exacerbate CNS inflammation in experimental multiple sclerosis. Dietary wheat ATI activate murine and human myeloid cells. The amount of ATI present in an average human wheat-based diet caused mild intestinal inflammation, which was propagated to extraintestinal sites, leading to exacerbation of CNS inflammation and worsening of clinical symptoms in EAE. These results support the importance of the gut-brain axis in inflammatory CNS disease. |
Gastrointestinal syndromes preceding a diagnosis of Parkinson's disease: testing Braak's hypothesis using a nationwide database for comparison with Alzheimer's disease and cerebrovascular diseases. Dysphagia, gastroparesis, IBS without diarrhoea and constipation might specifically predict Parkinson's disease. |
| Hepatology |
Clinical decision support and electronic interventions to improve care quality in chronic liver diseases and cirrhosis. Yet, CDS systems have had a mixed record in clinical medicine due to issues with interoperability and compatibility with clinical workflows. In this review, we discuss the conceptual origins of CDS systems, existing applications in liver diseases, issues and challenges with implementation, and emerging strategies to improve their integration in hepatology care. |
Development and validation of a prognostic score to identify the optimal candidate for preemptive TIPS in patients with cirrhosis and acute variceal bleeding. We developed and validated a clinical prediction model that can help to identify individuals who will benefit from p-TIPS, which may guide clinical decision-making. |
Dual elastography to discriminate adjacent stages of fibrosis and inflammation in chronic hepatitis B: A prospective multicenter study. Dual elastography demonstrated high performance in the continuous discrimination of fibrosis and inflammation in HBV patients and could be used to diagnose mild fibrosis without influence of inflammation. |
Emerging and potential use of CRISPR in human liver disease. It is also being studied for treatment of hepatitis B infection. CRISPR is an exciting, evolving technology that is facilitating gene characterization and discovery in liver disease and holds the potential to treat liver diseases safely and permanently. |
Geospatial analysis of cyanobacterial exposure and liver cancer in the contiguous United States. These findings emphasize the importance of environmental exposure to cyanobacteria as a location-based determinant of mortality from liver cancer. Public health initiatives addressing CE may be considered to reduce mortality, particularly in areas of high social vulnerability. |
Metabolic reprogramming in Nrf2-driven proliferation of normal rat hepatocytes. Many metabolic changes in cancer cells are shared by proliferating normal hepatocytes in response to a hostile environment. Nrf2 activation is essential for bridging metabolic changes with crucial components of cancer metabolic reprogramming including the activation of oxidative PPP. Our study demonstrates that matured hepatocytes exposed to LN undergo a cancer-like metabolic reprogramming and offers a rapid and useful in vivo model to study the molecular alterations underpinning the differences/similarities of metabolic changes in normal and neoplastic hepatocytes. |
The global fatty liver disease Sustainable Development Goal country score for 195 countries and territories. The fatty liver disease-SDG score provides a strategic advocacy tool at the national and global levels for the liver health field and noncommunicable disease advocates, highlighting the multisectoral collaborations needed to address fatty liver disease, and noncommunicable diseases overall. |
The utility of P-I-R classification in predicting the on-treatment histological and clinical outcomes of patients with hepatitis B and advanced liver fibrosis. The P-I-R classification can be a meaningful complementary to the Ishak fibrosis score not only in evaluating the histological changes but also in predicting the clinical outcomes. |
| J Hepatol |
A fetal wound healing program after intrauterine bile duct injury may contribute to biliary atresia. The fetal/neonatal EHBD, including in human EHBD remnants from Kasai surgeries, demonstrated an injury response with prolonged high levels of HA typical of fetal wound healing. The expanded peri-luminal HA layer may swell and lead to elevated bilirubin levels and obstruction of the EHBD. |
Biliary atresia is associated with polygenic susceptibility in ciliogenesis and planar polarity effector genes. Biliary atresia is associated with polygenic susceptibility in CPLANE genes. Rare variants contribute to polygenic risk in vulnerable pathways via unique genes. Impact and implications Liver transplantation is needed to cure most children born with biliary atresia, a poorly understood rare disease. Transplant immunosuppression increases the likelihood of life-threatening infections and cancers. To improve care by preventing this disease and its progression to transplantation, we examined its genetic basis. We find that this disease is associated with both common and rare mutations in highly specialised genes which maintain normal communication and movement of cells, and their organization into bile ducts and blood vessels during early development of the human embryo. Because defects in these genes also cause other birth defects, our findings can lead to preventive strategies to lower the incidence of biliary atresia and potentially other birth defects. |
Combined inhibition of surface CD51 and To sum up, we revealed previously unrecognized action mechanisms of CD51 on HCC progression and uncovered the underlying cause of cilengitide treatment failure and supported the translational prospects of combined CD51-targeted therapy in the clinic. Impact and implications Integrin av (CD51) is a widely recognized pro-tumoral molecule that plays a crucial role in various stages of tumor progression, making it a promising therapeutic target. However, despite early promising results, cilengitide, a specific antagonist of CD51, surprisingly failed in the phase 3 clinical trial. This prompted further investigation into the underlying mechanisms. This study reveals that the |
Progression of nonalcoholic fatty liver disease and long-term outcomes: A nationwide paired liver biopsy cohort study. In a nationwide, real-world cohort of patients with paired NAFLD biopsies, histological disease progression contributed to significantly higher rates of developing incident ESLD, but did not appear to impact all-cause mortality. Impact and implications Currently, data are scarce regarding the long-term impact of nonalcoholic fatty liver disease (NAFLD) histological progression or regression on subsequent risk of adverse clinical outcomes, including the development of end-stage liver disease (ESLD) and mortality. This is particularly important because randomized controlled trials of NAFLD therapeutics currently focus on short-term histological endpoints as presumed surrogates for those major clinical outcomes. Thus, the results from this study can help inform the optimal design of future NAFLD therapeutic trials, while also providing the necessary evidence base for public health policies focused on preventing the development and progression of NAFLD. |
| J Neurogastroenterol Motil |
A Higher Manometric Esophageal Length to Height Ratio in Achalasia Explains the Lower Prevalence of Hiatal Hernia. The prevalence of HH in achalasia is significantly lower than in GERD. The longer EL and the higher MELH ratio in achalasia could explain the lower prevalence of HH. Despite the low prevalence of HH in achalasia patients, the surgeon should be encouraged not to rule out HH since the risk of postoperative reflux may increase if this condition is not identified and corrected. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
Emerging and current management of acute-on-chronic liver failure. The recognition of ACLF as a distinct entity from acutely decompensated cirrhosis has allowed for better patient stratification in clinical settings, facilitating earlier engagement with the intensive care unit and liver transplantation teams. Research priorities over the next decade should focus on exploring novel treatment strategies with a particular focus on which, when, and how patients with ACLF should be treated. |
Review article: Externally derived control arms-An opportunity for clinical trials in inflammatory bowel disease? While this approach has several pitfalls, and is not robust enough to replace traditional randomised, placebo-controlled trials, it may offer a compromise to address key research questions at a more rapid pace, with fewer patients, and lower cost. |
| Endosc Int Open |
| Gastrointest Endosc |
| J Hepatol |
IgG4-related cholangitis - a mimicker of fibrosing and malignant cholangiopathies. For remission induction glucocorticosteroids are highly effective, after which immunomodulators can be introduced for maintenance of remission as glucocorticosteroid sparing alternatives. Increased insight into the pathogenesis of IRC will lead to improved diagnosis and novel therapeutic strategies in the future. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Gastroenterology |
|---|
| Gastrointest Endosc |
| Gut |
| J Hepatol |